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If there were more palliative care in Ontario, there'd be less need for physician-assisted death, says Sarnia's lead palliative care doc.

“I think that would probably take care of 95 per cent of people. I really do,” Dr. Glen Maddison, medical director of St. Joseph's Hospice in Sarnia, said Tuesday

“Because what is it? It's the fear, the fear of suffering that drives most people.

“There's certainly a dignity issue — I understand that, and that's a tough one to get around — but if it's symptoms, we can treat their symptoms.”

Maddison's comments came during a broad conversation about palliative care, opioid drug use, and what he and fellow palliative doctors have termed 'hastening death' during a forum presentation at Central United Church.

Physician-assisted death is an imperfect term, he said, referring to the words widely used to describe a doctor helping a person grievously and irremediably suffering to die.

The Supreme Court of Canada ruled last year that to do so is legal, and has given legislators until June to enact laws governing the practice.

But helping people die, as a process, is something Maddison said he and other palliative care doctors do daily.

“I keep people comfortable and a lot of my patients are dying,” he said. “I assist them to do that, I help them die. I just don't shorten their life.”

Palliative care is about providing comfort, physically with drugs like morphine, he said, but also providing comforts like friendship, relaxation.

It's about helping people to die peacefully, and to live well until they die, Maddison said.

But there's simply not enough palliative care, he said, noting just 15 per cent of people in Canada who need palliative care actually receive it.

Maddison said Sarnia is ahead of most communities, with a 10-bed hospice and eight-10-bed palliative care ward in hospital.

But elsewhere, resources are not as abundant.

A big part of that, he said, is a lack of training for doctors in medical school, where he said they generally receive only a few hours of palliative care training.

Many, he said, shy away from having anything to do with palliative care, uncomfortable with the idea of their patients dying.

Maddison teaches a two-day course three to four times a year to doctors, pharmacists and social workers to try and dispel myths and soothe fears.

Meanwhile, Maddison said, hastening death threatens to undermine the role of palliative care.

“That's our struggle,” he said. “Are there going to be people who act impulsively and won't come to us when we can help them with their symptoms?”

In general too, he said, hastening death goes against his own beliefs, and he worries that doctors of like mind will leave the province as Ontario's College of Physicians and Surgeons is poised to require physicians who conscientiously object to still make referrals to doctors who will help hasten death.

Other provinces, like Quebec, only require patients be given details so they can seek another doctor.

A recent London Free Press report noted some doctors are already looking to move their practices somewhere out of province.